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The following template will guide you in providing the minimum data needed for your community
needs assessment. Please refer to the Safe Kids Worldwide Guide to Conducting a Community
Needs Assessment for potential sources to assist you in completing this form. Additional information
regarding childhood injury in the geographical coverage area may also be attached.
I.
i. Rural
ii. Urban
c. Map
3,067
3,153
2,990
Percent
34,543
5,296
427
315
607
5,254
Percent
11.4%
0.9%
0.6%
16,908
Urban:
8,291
Rural:
8,617
2
Percent
9.3%
7.3%
15.5%
13.3%
14.7%
20.6%
8.7%
8.3%
0.9%
1.4%
2.
2010
2011
Rank the top six injury risk areas in your community. What factors contribute to the high
number of injuries and deaths in these areas? (ex. Open bodies of water, low frequency of smoke
detector use.)
3.
2012
Rank
2
5
4
3
6
1
7
Please complete the charts below using the top five risk areas in your community and the
population data available for the most recent three years.
Rates are calculated as number of injuries or deaths per 100,000 population
Rates based on 1-4 events are not shown and indicated by an *.
Injuries and Injury Rates (per 100,000 children) for (Polk) County Children Ages 0-19
2010
MVC
Falls
Drowning
Shootings
Fire/smoke
Poisoning
Suffocation
2011
Disch
arges
Rate
ER
Visits
Rate
Disch
arges
Rate
ER
Visits
Rate
Disch
arges
4
0
0
1
2
2
0
*
0.0
0.0
*
*
*
0.0
157
556
0
10
5
41
0
1297.9
4596.6
0.0
82.7
41.3
339.0
0.0
4
1
1
0
1
2
1
*
*
*
0.0
*
*
*
155
637
2
5
7
40
1
1308.2
5376.4
*
42.2
59.1
337.6
*
5
2
0
0
0
0
0
2012
ER
Rate
Visit
s
42.4
*
0.0
0.0
0.0
0.0
0.0
132
546
1
4
4
23
0
Rate
1118.7
4627.5
*
*
*
194.9
0.0
Source: OASIS, Georgia Department of Human Resources, Division of Public Health, Office of Health Information
and Policy
MVC
Falls
Drowning
Shootings
Fire/smok
e
Poisoning
Suffocatio
n
1-4
Discharge
s
Rate
ER Visits
Rate
Discharge
s
Rate
ER
Visits
0.0
0.0
0.0
12
24
4316.5
159
0
0
0.0
0.0
0
0
0.0
0.0
0
0
0.0
0.0
0
0
477.9
6332.
1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
14
557.5
0.0
0.0
0.0
0.0
2012
injuries
(cont.)
10-14
Age: 5-9
Disch
arges
Rate
Rate
412.3
0.0
30
1003.3
138
4376.8
0.0
130
0.0
0.0
0.0
0.0
0.0
0.0
Rate
ER
Visits
13
0.0
0
0
Rate
15-17
ER
Visits
Disch
arges
MVC
Falls
Drowning
Shootings
Fire/smoke
Poisoning
Suffocation
Rate
Disch
arges
Rate
ER
Visit
s
Rate
40
2542.9
4347.8
0.0
68
4322.9
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
MVC
Falls
Drowning
Shootings
Fire/smok
e
Poisoning
Total
Discharge
s
Rate
ER Visits
37
0.0
0
0
0
0.0
0.0
0.0
0
2
1
3641.
7
2657.
5
0.0
*
*
0.0
27
Rate
Discharge
s
Rate
ER
Visits
42.4
132
546
0
0
0.0
0.0
1
4
1118.
7
4627.
5
*
*
0.0
0.0
23
194.9
Rate
Suffocatio
n
0.0
0.0
0.0
0.0
Source: OASIS, Georgia Department of Human Resources, Division of Public Health, Office of Health Information
and Policy
1-4
Discharge
s
Rate
ER Visits
Rate
0.0
0.0
29
0
0
0.0
0.0
MVC
Falls
Drowning
Shootings
Fire/smok
e
Poisoning
Suffocatio
n
Discharge
s
Rate
ER
Visits
0.0
12
191
0
0
*
5034.
7
0.0
0.0
1
0
*
0.0
2
1
461.2
7340.
5
*
*
0.0
0.0
0.0
0.0
28
1076.
1
0.0
0.0
0.0
2011
injuries
(cont.)
Age: 5-9
10-14
Disc
harg
es
Rate
605.9
154
4910.7
Disch
arges
Rate
ER
Visits
19
0.0
MVC
Falls
Drowning
Shootings
Fire/smoke
Poisoning
Suffocation
Rate
Rate
15-17
ER
Visits
Rate
Disc
harg
es
Rate
ER
Visits
Rate
0.0
51
1728.2
0.0
35
2232.1
0.0
0.0
172
5828.5
0.0
59
3762.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
159.4
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
MVC
Falls
Drowning
Total
Discharge
s
Rate
ER Visits
37
0.0
0.0
32
0
Rate
3645.
3
3152.
7
0.0
Discharge
s
Rate
ER
Visits
155
637
Rate
1308.
2
5376.
4
*
Shootings
Fire/smok
e
Poisoning
Suffocatio
n
0
0
0.0
0.0
0.0
42.2
59.1
0
0
0.0
0.0
40
337.6
0.0
Source: OASIS, Georgia Department of Human Resources, Division of Public Health, Office of Health Information
and Policy
Rate
ER
Visits
Rate
Discharg
es
Rate
ER
Visits
Rate
0
0
0
0
0.0
0.0
0.0
0.0
3
22
0
0
*
3678.9
0.0
0.0
2
0
0
0
*
0.0
0.0
0.0
9
160
0
0
333.5
5928.1
0.0
0.0
0.0
0.0
0.0
28
1037.4
0.0
0.0
0.0
0.0
MVC
Falls
Drowning
Shootings
Fire/smok
e
Poisoning
Suffocatio
n
2010
injuries
(cont.)
MVC
Falls
Drowning
Shootings
Fire/smoke
Poisoning
Suffocation
1-4
Age: 5-9
Disch
arges
Rate
ER
Visits
0.0
29
0.0
133
0.0
0
0
0
0
Rate
Disch
arges
15-17
10-14
Rate
ER
Visits
Rate
Disc
harg
es
Rate
0.0
0.0
ER
Visits
Rate
34
2100.1
47
2903.0
0.0
0.0
0.0
924.2
0.0
37
4238.4
0.0
152
0.0
0.0
1240.
4
5095.
5
0
0.0
0.0
167.6
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
MVC
Total
Discharge
s
Rate
ER Visits
Rate
Discharge
s
Rate
ER
Visits
Rate
45
4249.
3
157
1297.
9
Falls
Drowning
Shootings
Fire/smok
e
Poisoning
Suffocatio
n
0.0
42
0
1
0.0
*
0
1
3966.
0
0.0
*
0.0
556
0
1
0.0
*
0
10
4596.
6
0.0
82.7
0.0
41.3
0.0
41
339.0
0.0
0.0
0.0
0.0
Source: OASIS, Georgia Department of Human Resources, Division of Public Health, Office of Health Information
and Policy
(Polk) County Injury Mortality Statistics for children ages 19 and under:
2010
Deaths
2011
Death
Rate
Deaths
2012
Death
Rate
Deaths
Death
Rate
0
0.0
MVC
1
*
3
*
Falls
0
0.0
0
0.0
0
0.0
Drowning
0
0.0
0
0.0
0
0.0
Shootings
0
0.0
0
0.0
0
0.0
Fire/smoke
0
0.0
0
0.0
1
*
0
0.0
0
0.0
0
0.0
Poisoning
0
0.0
0
0.0
0
0.0
Suffocation*
*Suffocation from items in bed, inhalation of gastric contents, food, airtight space, or plastic bag
Source: OASIS, Georgia Department of Human Resources, Division of Public Health, Office of Health Information
and Policy
1.Whoisathighrisk?
Usingyourlocalinjuryanddeathdata,compareitwithstateandnationalinjurystatistics.
(www.cdc.gov/ncipc/
wisqars
/)andthenanswerthefollowingquestions.
UnitedStatesInjuryRates(per100,000childrenages19andyounger)
Injury rate
2010
2011
MVC
1,310.20
1,264.19
Falls
3,457.43
3,473.93
Drowning
7.22
6.90
Shootings
3.63
3.48
Fire/smoke
154.30
164.60
Poisoning
154.08
157.34
Source:www.cdc.gov/ncipc/wisqars/
2012
1,22.85
3,409.44
6.32
3.25
165.43
152.18
StateofGeorgiaInjuryRates(per100,000childrenages19andyounger)
Injury rates
MVC
2010
Discharge
ER Visit
39.8
755.1
2011
Discharge
ER Visit
38.3
759.9
2012
Discharge
ER Visit
34.0
761.2
25.2
2,644.6
Falls
26.3
2,522.1
24.7
2,656.5
1.5
5.9
Drowning
1.8
6.1
2.1
5.0
2.2
19.3
Shootings
2.0
20.6
2.4
21.9
3.3
18.4
Fire/smoke
4.2
21.1
3.9
22.3
10.7
142.0
Poisoning
11.5
143.9
11.3
151.7
0.5
16.3
Suffocation
1.1
12.2
1.1
19.3
Source: OASIS, Georgia Department of Human Resources, Division of Public Health, Office of Health Information
and Policy
UnitedStatesDeathRates(per100,000childrenages19andyounger)
Death Rates
MVC
Falls
Drowning
Shootings
Fire/smoke
Poisoning
2010
2011
5.15
4.95
0.17
0.15
1.17
1.23
0.17
0.16
0.39
0.44
1.01
1.01
*2011datanotavailableatthistime
Source:www.cdc.gov/ncipc/
wisqars
StateofGeorgiaDeathRates(per100,000childrenages19andyounger)
2010
2012
Death rate
2011
6.8
4.4
MVC
5.6
0.22
*
Falls
*
1.7
1.1
Drowning
1.4
0.29
0.2
Shootings
*
0.25
0.3
Fire/smoke
0.5
0.8
0.3
Poisoning
1.2
0.4
0.3
Suffocation
0.4
Source: OASIS, Georgia Department of Human Resources,
Division of Public Health, Office of Health Information and Policy
Female
Male
Total
alcohol
Drove when drinking alcohol
Texted or e-mailed while driving a car or other
vehicle
2011
Never or rarely wore a bicycle helmet
Never or rarely wore a seat belt
Rode with a driver who had been drinking
alcohol
22.7) 963
5.4 (3.6-8.1)
541
37.0 (30.843.7) 553
25.2) 999
7.4 (4.5-11.9)
595
35.5 (29.841.6) 633
23.4) 1,977
6.5 (4.7-9.1)
1,143
36.6 (31.342.2) 1,197